Unit 2: Physiology and Health - Key Area 7: Pathology of Cardiovascular Disease Flashcards

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1
Q

What is atherosclerosis?

A

Atherosclerosis is the formation and build up of plaque underneath the endothelium of the artery wall.

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2
Q

What are the plaques made of in atherosclerosis?

A

The plaques are made of fatty material (made up mainly of cholesterol but as the years go on, fibrous material and calcium also build up).

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3
Q

What can the plaque that forms and builds up through atherosclerosis also be called?

A

An atheroma.

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4
Q

What can an atheroma also lead to?

A
  • Arteries becoming blocked/clogged and loses its elasticity.
  • Reduced blood flow in the artery
  • Reduced diameter of lumen of artery leading to increased blood pressure.
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5
Q

What is atherosclerosis also called and why is this?

A

Atherosclerosis is sometimes called “hardening of the arteries” because the large plaques can become hardened by deposits of calcium.

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6
Q

What cardiovascular diseases is atherosclerosis the cause of?

A
  • Coronary heart disease (including angina)
  • Strokes
  • Heart attack’s
  • Peripheral vascular disease
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7
Q

If Atheromas on the lining inside an artery become enlarged what might happen?

A

If Atheromas on the lining inside an artery become enlarged they can burst through the endothelium and damage it. If this happens, clotting might occur.

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8
Q

What is a thrombosis?

A

Thrombosis is the formation of a blood clot (thrombosis) in a vessel.

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9
Q

What is blood clotting primarily?

A

Blood clotting is a protective reaction which is triggered by damage to cells. This damage triggers the release of clotting factors that activate a series of reactions.

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10
Q

What is the series of reactions that occur when clotting factors are released?

A

Prothrombin (the inactive enzyme) is converted into thrombin (the active enzyme) by the clotting factors. The thrombin then promotes the conversion of fibrinogen (insoluble) into threads of fibrin(soluble). The threads of fibrin form a mesh network that traps blood platelets and blood cells creating a clot. This provides a scaffold for scar tissue.

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11
Q

If the blood clot becomes break loose/dislodged and becomes mobile what may form?

A

An embolus.

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12
Q

What can an embolus do?

A

An embolus is carried in the blood until it reaches a narrow vessel, where it blocks the vessel and causes blood flow to be severely restricted or even stop it completely.

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13
Q

Blockage of a coronary artery by a thrombus such as an embolus is also called?

A

A coronary thrombus

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14
Q

What can be the result of a coronary thrombus?

A

It stops oxygen from getting to the heart muscle and can lead to a myocardial infarction (MI) also known as a heart attack.

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15
Q

A thrombus that causes a blockage in an artery to the brain may lead to a?

A

Stroke.

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16
Q

How can strokes be damaging to tissue?

A

If the cells do not have a supply of oxygen, this leads to the death of tissue.

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17
Q

What is prothrombin?

A

An inactive enzyme.

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18
Q

What is thrombin?

A

An active enzyme.

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19
Q

Is fibrinogen insoluble?

A

Yes

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20
Q

Is fibrin insoluble?

A

No it is soluble.

21
Q

What are the peripheral arteries?

A

The peripheral arteries are any arteries apart from those of the heart or the brain.

22
Q

What happens when any of the peripheral arteries are affected by atherosclerosis?

A

Their central cavity becomes narrower, which leads to peripheral vascular disease.

23
Q

What arteries does peripheral vascular disease normally affect?

A

Arteries in the legs.

24
Q

When blood vessels have a blockage due to peripheral vascular disease what is normally felt and why is this?

A

Blood flow is restricted and pain is felt in the muscles because they are not receiving enough oxygen.

25
Q

What is an example of a peripheral vascular disease, why is this caused and what does this cause?

A

Deep vein thrombosis (DVT), which is the formation of a thrombus in a vein, most commonly in the lower leg. This causes pain and swelling and veins close to the surface become swollen with blood.

26
Q

If a DVT breaks loose what can it result in?

A

A pulmonary embolism.

27
Q

How does a pulmonary embolism work?

A

The clot is transported to the heart by the Vena Cava where it can then block the pulmonary artery and cause a pulmonary embolism.

28
Q

What is the role of the enzyme thrombin in blood clotting?

A

Promotes the conversion of fibrinogen (insoluble) into fibrin which is soluble and will help/cause clott.

29
Q

What is the heart not getting a supply of during a heart attack?

A

Oxygen and as it is a muscle it can no longer respire to produce energy needed for it to contract so no/little blood is pumped around the body.

30
Q

What is the treatment for a pulmonary embolism?

A

Anticoagulant

31
Q

What is cholesterol?

A

Cholesterol is a type of lipid required by the body.

32
Q

Why is cholesterol required by the body?

A
  • It is a component of every cell membrane.

- it is required to make the sex hormones - testosterone, oestrogen and progesterone.

33
Q

What is cholesterol made by?

A

Cholesterol is made by all cells, although 25% of total cholesterol is produced in the liver.

34
Q

How is blood cholesterol raised?

A

By a diet high in saturated fat or cholesterol.

35
Q

What are lipoproteins?

A

Molecules consisting of lipids and proteins.

36
Q

Where are lipoproteins present and what do they do?

A

In blood plasma and transport lipids from one part of the body to another.

37
Q

What are the two types of lipoproteins?

A

Low-density lipoproteins (LDLs) and High density lipoproteins (HDLs).

38
Q

What is cholesterol transported to body cells by?

A

LDLs

39
Q

What do LDL receptors do?

A

LDL receptors which are present in most cell take LDLs into the cell where it releases the cholesterol.

40
Q

How does the negative feedback of LDLs work and what can this cause?

A

There is a negative feedback effect whereby a high concentration of cholesterol in the cell inhibits synthesis of new LDL receptors. LDL therefore circulates in the blood instead where it may deposit cholesterol in the arteries forming atheromas.

41
Q

Is LDL bad or good for us?

A

Bad we should aim to lower LDLs in the diet.

42
Q

What do HDLs do?

A

HDLs transport excess cholesterol from the body cells to the liver for elimination.

43
Q

Are HDLs good for us?

A

Yes as they reduce levels of cholesterols in the blood.

44
Q

What are some ways of reducing cholesterol levels?

A
  • Undertake regular physical activity in order to raise HDL levels
  • Dietary changes to reduce the total fat intake and to replace saturated fats with unsaturated fats, which helps to maintain a healthy HDL:LDL ratio.
  • If necessary prescription drugs such as statins can be taken which reduce blood cholesterol by inhibiting the synthesis of cholesterol by liver cells.
45
Q

What are lipoproteins?

A

Molecules containing lipids and proteins.

46
Q

Where in the blood is most cholesterol produced?

A

The liver

47
Q

Why are LDLs known as “bad cholesterol”?

A

They can cause atheromas.

48
Q

What type of drugs can be prescribed to lower cholesterol levels?

A

Statins

49
Q

How does the negative feedback of LDLs work?

A
  • Cell has adequate supply of cholesterol.
  • Synthesis of new LDL receptors is inhibited.
  • Less LDL is absorbed by cells
  • LDL - cholesterol is taken up by endothelial cells lining the inside of an artery.
  • Cholesterol is deposited in an atheroma in the wall of the artery.